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Effect of 16F gastric tube as thoracic drainage tube on pain relief in patients after lung cancer resection: A controlled trial

Objective To explore the effect of 16F gastric tube on pain relief in postoperative lung cancer patients. Methods A total of 118 lung cancer patients were treated with radical resection of lung cancer in our hospital between January 2015 and May 2016. The patients were assigned into two groups: a 16F gastric tube group (16F group, 60 patients, 30 males and 30 females at age of 41-73 (52.13±7.83) years and a 28F drainage tube group (28F group, 58 patients, 25 males and 33 females at age of 45-75 (55.62±4.27) years. Clinical effects were compared between the two groups. Results There was no statistical difference in drainage time (4.47±1.03 dvs. 4.24±1.16 d, P=0.473), drainage amount (560.37±125.00 mlvs. 656.03±132.45 ml, P=0.478), incidences of pneumothorax (5/60 vs. 2/58, P=0.439), pleural effusion (6/60 vs. 3/58, P=0.522), and subcutaneous emphysema (3/60 vs. 1/58, P=0.635) between the two groups (P>0.05). The pain caused by the drainage tube in the16F group was less than that in the 28F drainage tube group with a statistical difference (F=4 242.996, P<0.001). The frequency of taking analgesics in the 16F group was significantly less than that in the 28F group (12/60vs. 26/58, P<0.001). Conclusion The effects of draining pleural effusions and promoting lung recruitment are similar between the 16F group and the 28F group. However, the wound pain caused by 16F gastric tube is significantly less than that by 28F drainage tube.

留置胃管患者非计划性自行拔管的相关因素分析及对策

摘要:目的:调查留置胃管患者在留置期间发生非计划性自行拔管的发生及相关因素,并探索护理对策。方法:调查218例留置胃管患者中非计划性自行拔管的发生情况,并分析导致非计划性自行拔管的相关因素。结果:在218例留置胃管患者中发生非计划性自行拔管 62例,小于45岁患者非计划性自行拔管发生率为39.5%,大于45岁患者非计划性自行拔管发生率为21.2%,前者高于后者并有显著性意义,癌症患者非计划性自行拔管发生率为36.4%,炎症(急性胰腺炎)疾病患者非计划性拔管为29%,其他疾病患者非计划性拔管为18.6%,癌症患者和急性重症胰腺炎高于后一组患者有显著意义,舒适的改变、约束不当、健康教育不到位、巡视不及时是造成非计划性拔管的。结论:对留置胃管患者心理护理应贯穿其患病的全过程,在操作前做好健康教育,手术患者应有效的固定肢体,对留置胃管造成的不适,给予对症护理,并增加护理人员加强巡视沟通,以减少非计划性自行拔管的发生。

小卡子在防止重症患者胃内容物外溢中的应用及效果

目的　总结和验证小卡子在防止危重患者肠内营养液及管喂药物后2 h内发生外溢的方法及效果。 方法　2011年5月－8月将ICU收治的80例需管喂的危重患者，随机分为两组，对照组采用传统的胃管末端盖子封闭胃管，试验组采取胃管远端加设小卡子夹闭胃管封闭法，比较两种方法在预防胃内容物外溢中的作用及效果。 结果　试验组患者无1例发生胃内容物外溢，两组比较差异有统计学意义（P＜0.05）。小卡子夹闭胃管可有效防止胃内药物或营养物质丢失。 结论　在胃管远端使用小卡子夹闭胃管的方法能有效降低胃内容物外溢发生率。

Evaluation of Efficacy of Local Spraying Anaesthesis in Preoperative Implantation of Nasogastric Tube inPatients with Laryngeal Carcinoma

目的：比较常规鼻胃管置入法与鼻咽部局部喷雾麻醉后置胃管法对喉癌患者的影响。方法：将需要安置胃管的100例患者随机分成两组，每组50例。实验组行鼻咽部喷雾麻醉，对照组按常规操作，比较两组患者流泪、恶心、呕吐、咳嗽反应，一次成功率及插管所需要时间、插入中暂停次数。结果：实验组一次成功率高，患者反应轻，插管所需时间有显著差异。结论：常规置胃管常因病员难受而中途暂停置管，实验组置胃管前先作鼻咽部局部喷雾麻醉，可明显减轻患者的痛苦，提高插胃管的一次成功率，插管过程中因病员难受暂停次数也明显减少，使临床护理工作时间缩短，对临床护理工作有积极意义。

急性胰腺炎患者胃管留置中发生心搏骤停一例

Feasibility Analysis of Early Removing Nasogastric Tube Following Pancreaticoduodenectomy:A Retrospective Comparative Study of Homochronous Patients

ObjectiveTo assess the safety for removing nasogastric tube(NGT)within postoperative 24 h in Whipple pancreaticoduodenectomy (PD)patients. MethodsThe clinical data of 310 patients performed classic Whipple PD from January 2008 to March 2013 in this hospital were analyzed retrospectively. The patients were divided into early (≤24 h after operation)removing NGT group and late( > 24 h after operation)removing NGT group according to the time of NGT duration. The ratio of NGT reinsertion, time of solid diet tolerance, hospital stay, mortality, and major complications associated with PD were compared between two groups. Results①The demography and preoperative comorbidities characteristics were similar(P > 0.05).②There was no statistical difference of ratio of NGT reinsertion between two groups(P=0.450).③The differences of rates of major complications associated with PD and mortality were not statistically different(P > 0.05)by univariate analysis, but the rate of total complications in the early removing NGT group was significantly lower than that in the late removing NGT group (P=0.014)by multivariate analysis.④The average time of solid diet tolerance(P=0.013)and average hospital stay(P < 0.001)in the early removing NGT group were significantly shorter than those in the late removing NGT group. ConclusionFor patients comfort, NGT following PD should be removed as early as possible even immediately after extubation for selective patients.

留置鼻胃管位置判断方法应用及研究现状

针对目前国内外临床确认留置鼻胃管位置的方法，该文分析和总结了各国相关的指南或专家推荐，对检测依据、相关研究和国内外应用情况现状进行了综述，以期为临床护理工作者提供参考和借鉴。通过引进国外适用方法，应用于临床留置鼻胃管位置的正确判断，有利于保障患者鼻饲安全，减轻患者痛苦，减少不良事件的发生，促进护理质量的持续改进。

Clinical Application of Nasogastric Tube in Perioperative Period of Colorectal Surgery

目的　探讨在结直肠手术围手术期中不常规应用鼻胃管的重要意义及其可行性。方法　选取2007年7月至2008年4月期间的结直肠手术患者40例，随机平均分为不留置鼻胃管和留置鼻胃管2组，记录２组各临床指标及并发症发生情况，并进行统计学分析。结果　不留置鼻胃管组患者舒适度增加，首次排气、排便及住院时间缩短（Plt;0.05），住院费用也相应降低（Plt;0.05），肺炎、肺不张、切口感染等并发症发生率低（Plt;0.05）。结论　结直肠手术不常规放置鼻胃管安全、可行，对减轻患者痛苦、减少术后并发症的发生率、缩短患者住院时间有重要意义。

倒置胃管治疗残胃手术后食管癌一例

一次性胃管应用于肺叶切除术后胸腔闭式引流的临床研究

目的探讨采用一次性胃管作为肺癌肺叶切除术后引流管的疗效及护理。 方法将2014年1月－7月行肺癌肺叶切除术的60例患者随机均分为试验组和对照组，试验组应用一次性胃管作为胸腔引流管治疗，对照组应用常规硅胶管作为胸腔引流管治疗，对比分析两组患者的胸腔引流管堵塞情况、伤口疼痛程度、胸腔引流管拔管时间、胸腔引流管拔管后引流口渗液情况及术后平均住院时间。 结果两组患者的胸腔引流管均无堵塞。试验组患者伤口疼痛评分低于对照组；试验组平均拔管时间（2.43±1.36）d，对照组平均拔管时间（3.77±1.87）d；试验组4例（13.3%）拔引流管后引流口有渗液，对照组13例（43.3%）；试验组术后平均住院日为（3.50±1.38）d，对照组为（4.93±1.86）d；两组比较差异有统计学意义（P＜0.05）。 结论一次性胃管应用于肺癌肺叶切除术后胸腔闭式引流，材质柔软，患者疼痛减轻，方便离床活动，进一步促进伤口愈合和肺功能恢复，缩短拔管时间及术后平均住院时间，减轻患者经济负担。